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Bekrater-Bodmann R, Reinhard I, Diers M, Fuchs X, Flor H. Relationship of prosthesis ownership and phantom limb pain: results of a survey in 2383 limb amputees. Pain 2021; 162:630-640. [PMID: 32868751 DOI: 10.1097/j.pain.0000000000002063] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/03/2020] [Indexed: 01/09/2023]
Abstract
ABSTRACT Phantom limb pain (PLP) accounts for a significant reduction in quality of life and is difficult to treat. Prosthesis use has been shown to negatively covary with PLP. Recent research on body perception in amputees suggest that prosthesis ownership, defined as the extent to which a prosthesis is experienced as being part of the body rather than an artificial device foreign to the body, might interact with PLP. We used survey data from 2383 unilateral prosthesis-using upper-limb or lower-limb amputees and performed regression analyses to determine the relationship between prosthesis ownership and PLP. To test for specificity, we examined the role of prosthesis ownership also for residual limb pain (RLP) and nonpainful phantom limb sensations (npPLS). Prosthesis ownership was reduced in older participants and higher in lower-limb compared to upper-limb amputees. A longer residual limb and more frequent prosthesis use as well as a longer time since amputation also yielded higher values. Prostheses based on natural principles were associated with higher prosthesis ownership. Phantom limb pain and RLP were lower with higher prosthesis ownership, and RLP but not PLP was lower when prosthesis use was frequent. There were no significant associations for npPLS. The regression results differ in some aspects from those revealed by univariate analyses, emphasizing the importance of multivariate statistical approaches. Our findings provide insights into the interplay of body- and pain-related sensations after amputation, and could help to develop new treatment approaches for both PLP and RLP.
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Affiliation(s)
- Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Reinhard
- Division of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Martin Diers
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Xaver Fuchs
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Biopsychology and Cognitive Neuroscience, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Health Science and Technology, Center for Neuroplasticity and Pain (CNAP), SMI , Aalborg University, Aalborg, Denmark
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Gordon C, Barbullushi A, Tombolini S, Margiotta F, Ciacci A, Yosef LS, Barker L, Martini M. Visuo-tactile stimulation, but not type of movement, modulates pain during the vision of a moving virtual limb. Pain Manag 2019; 9:449-460. [PMID: 31452455 DOI: 10.2217/pmt-2019-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Aim: Evidence has revealed a relationship between pain and the observation of limb movement, but it is unknown whether different types of movements have diverse modulating effects. In this immersive virtual reality study, we explored the effect of the vision of different virtual arm movements (arm vs wrist) on heat pain threshold of healthy participants. Patients & methods: 40 healthy participants underwent four conditions in virtual reality, while heat pain thresholds were measured. Visuo-tactile stimulation was used to attempt to modulate the feeling of virtual limb ownership while the participants kept their arms still. Results: Effects on pain threshold were present for type of stimulation but not type of movement. Conclusion: The type of observed movement does not appear to influence pain modulation, at least not during acute pain states.
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Affiliation(s)
- Calum Gordon
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Alba Barbullushi
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Stefano Tombolini
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Federica Margiotta
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Alessia Ciacci
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Lama Shekh Yosef
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Leon Barker
- Department of Arts & Digital Industries, University of East London, University Way, London E16 2RD, UK
| | - Matteo Martini
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
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